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11/23/1994 SECTI.DN 00500 FORM OF AGREEMENT Name: forth as of the ~3 ~ day of November in between the OWNER who is THE BOARD OF of Monroe County Florida; and the following -7' - '1 ~J \d z; U'I The Brewer Company of Florida I ~ :' c ==- :z r, CJ This agreement is set the year of 1994 COUNTY COMMISSIONERS CONTRACTOR: ./"" Address: 10400 N.W. 121 Way Miami, Florida 33178 rv .;j '1 -0 W (..j I.N 7J Phone: (305) 364-3595 for the purpose of performing all of the Work required by the Contract Documents for the following PROJECT: CUDJOE KEY ROADS I I Cudjoe Key Monroe County, Florida The Project has been designed by MONROE COUNTY ENGINEERING DEPARTMENT who is hereafter referred to as the ARCHITECT/ENGINEER and who assumes all duties and responsibilities and has the rights and authority assigned to the ARCHITECT/ENGINEER in the Contract Documents in connection with completion of the Work in accordance with the Contract Documents. The OWNER and the CONTRACTOR agree as set forth as follows: Article 1 - The Contract Documents The Contract Documents consist of this Agreement, the Request for Bid, the Conditions of the Contract (General and Supplementary), the Supplementary Insurance Documents, the Special Conditions, the General Requirements, the Technical Specifications, the Drawings, and all Addenda issued prior to and all Modifications issued after execution of this Agreement. These form the Contract, and all are as fully a part of the Contract as if attached to this Agreement or repeated herein. An enumeration of the Contract Documents appears in Article 7. 09/09/94 FORM OF AGREEMENT 00500-1 Article 2 - The Work The Contractor shall perform all the Work required by the Contract Documents for the following Scope of Work: A. The Scope of Work consists of roadway improvements to local subdivision streets in Cudjoe Key which includes base widening, regrading roadway shoulders, leveling, resurfacing, striping, temporary striping, sign relocation and new installation and other related roadway construction as included in the Technical Specifications. B. The Contractor shall: provide all labor, materials, supplies, equipment, tools, equipment, transportation, inspection, execution and completion of all Work as the Drawings and Technical Specifications. supervision, construction and proper specified on C. The Specifications contained herein be the minimum standards required. comply with all applicable Federal, and ordinances. are considered to Construction shall State, Local codes D. This contract is subject to the prov1s1ons of Section 255.05, F.S., and those provisions of Chapter 713, F.S., which are incorporated therein. E. This written contract and attached contract documents represent the entire agreement between the parties and may not be modified except as provided herein. F. This agreement is to be governed by the laws of the State of Florida. Article 3 - Schedule The CONTRACTOR shall commence Work to be performed under this Contract no later than ten (10) calendar days from Notice to Proceed and shall be substantially completed no later than one hundred and twenty (120) calendar days from the Commencement Date. The CONTRACTOR also agrees to be complete and ready for final payment in accordance with the General Conditions no later than thirty (30) calendar days from the Substantial Completion Date. Substantial Completion shall be determined by the County Engineer. The OWNER and the CONTRACTOR recognize that time is of the essence in this Contract and that the OWNER will suffer 10/11/94 FORM OF AGREEMENT 00500-2 financial loss if the Work is not completed within the times specified above, plus any extensions of time allowed in accordance with the General Conditions. They also recognize the delays, expense and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not completed on time. Accordingly, instead of requiring such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a penalty) CONTRACTOR shall pay OWNER fifty dollars ($50.00) for each day that expires after the time specified above for Substantial Completion until the Work is substantially complete. The OWNER and CONTRACTOR agree that work on the project will be continuous from the commencement date through to the completion date. Any demobilization once the work has started requires prior approval by the OWNER. Article 4 - Contract Price The OWNER shall pay the CONTRACTOR for completion of the Work in accordance with the Contract Documents in current funds in the following amount subject to uni t price actual quanti ty variations: $ Two hundred thirty six thousand six hundred (WORDS) and thirty one dollars and sixty eight cents Article 5 - Payment Procedures The CONTRACTOR shall submit accordance with the General Payment will be processed Conditions. $236,631.68 (DOLLARS) Applications Conditions. as provided for Payment in Applications for in the General The OWNER shall make progress payments on account of the Contract Price on the basis of the CONTRACTOR~S Application for Payment as recommended by the COUNTY ENGINEER once per month during construction. All progress payments will be on the basis of the progress of the Work measured in accordance with the General Conditions and Supplementary Conditions of the Contract. Payment will be made approximately one (1) month from the submission of the application if all documentation is complete. Retention in the amount of ten percent (10%) will be withheld from each progress payment until final payment is made. Upon final completion and acceptance of the Work in accordance with the General Conditions and upon submittal of all closeout documentation, and compliance with F.S.255.05 and F.S. 713, OWNER shall pay the remainder of the Contract Price, including release of retention, as recommended by the COUNTY ENGINEER. 09/09/94 FORM OF AGREEMENT 00500-3 Article 6 - Contractor's Representations In order to induce OWNER to enter into this Contract, CONTRACTOR makes the following representations: 1. CONTRACTOR has familiarized himself with the nature and extent of the Contract Documents, Work, site, locality, and all local conditions and Laws and Regulations that in any manner may affect cost, progress, performance, or furnishing of the Work. 2. The CONTRACTOR has studied carefully all reports of explorations and tests of subsurface conditions and drawings of physical conditions which are included in the Contract Documents. 3. The CONTRACTOR has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests, reports, and studies which pertain to the subsurface of physical conditions at or contiguous to the site or otherwise may affect the cost, progress, performance or furnishing of the Work as CONTRACTOR considers necessary for the performance or furnishing of the Work at the Contract Price, wi thin the Contract Time and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of paragraph 4.2 of the General Conditions; and no additional examinations, investigations, exploration, tests, reports, studies, or similar information or data be or will be required by the CONTRACTOR for such purposes. 4. The CONTRACTOR has reviewed and checked all information and data shown or indicated on the Contract Documents wi th respect to existing Underground Facilities at or contiguous to the site and assumes responsibility for the accurate location of said Underground Facilities. 5. The CONTRACTOR has correlated the results of all such observations, examinations, investigations, explorations, tests, reports, and studies with the terms and conditions of the Contract Documents. 6. The CONTRACTOR has given the OWNER written notice of all conflicts, errors, or discrepancies that he has discovered in the Contract Documents and the written resolution thereof by the OWNER is acceptable to the CONTRACTOR. 09/09/94 FORM OF AGREEMENT 00500-4 Article 7 - Contract Documents The Contract Documents which comprise the entire agreement between the OWNER and the CONTRACTOR concerning the Work consist of the following: 1. Notice of Award 2. This Agreement (pages 1 to 7, inclusive). 3. Public Construction Bond 4. Bidding Documents - Notice of Calling for Bids, Instructions to Bidders, Bid Proposal, Pre-Bid Substitutions, Scope of Work, Milestone Schedule 5. Notice to Proceed 6. General Conditions (pages 0 to 31, inclusive). 7. Supplementary Conditions (pages 1 to 2, inclusive). 8. Supplementary Insurance Documents (pages 1 to 11, inclusive) . 9. Special Conditions (pages 1-8, inclusive). 10. General Requirements - Measurement and Payment, Application for PaYment, SUbmittals, Progress Schedules, Temporary Controls, Construction Cleaning, and Post-Bid Substitutions. 11. Technical Specifications. 12. Drawings, consisting of a cover sheet and sheets numbered -1- through -1I- , inclusive with each sheet bearing the following general title: CUDJOE KEY ROADS II Cudjoe Key 13. Addenda numbers to , inclusive. 14. CONTRACTOR's Bid Proposal (pages 1 to 16, inclusive). There are no Contract Documents other than those listed above in this Article. The Contract Documents may only be amended, modified, or supplemented as provided in the General Conditions. 09/09/94 FORM OF AGREEMENT 00500-5 Article 8 - Indemnification and Hold Harmless Agreement. The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Contractor or any of its Subcontractor(s) in any tier, occasioned by the negligence or other wrongful act or omission of the Contractor or its Subcontractor ( s ) in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. Article 9 - Miscellaneous. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically but without limitation moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect of all covenants, agreements and obligations contained in the Contract Documents. 09/09/94 FORM OF AGREEMENT 00500-6 Article 10 - Other Provisions In cases of conflict wi thin the described Contract Documents in Article 7 of this Form of Agreement, the order of precedence shall be as follows: 1. This Agreement 2. Bidding Documents with all/any addenda 3. General Requirements 4. Supplementary Conditions 5. General Conditions 6. Technical Specifications 7. Drawings (large scale detail drawings over smaller scale general drawings) IN WITNESS WHEREOF, the OWNER and CONTRACTOR have signed this Agreement in quadruplicate. One counterpart each has been delivered to the OWNER, CONTRACTOR, COUNTY ENGINEER and COUNTY PURCHASING DEPARTMENT. All portions of the Contract Documents have been signed or identified by the OWNER and CONTRACTOR or by the COUNTY ENGINEER on their behalf. This Agreement will be effective on N OV'~<< d- 3> , 19~. OWNER: Monroe County BOCC The Brewer C..ompany of Florida Inc. CONTRACTOR " , Walter R. Brewer Monroe County, FL By cSlJA:~-F~a~w~ May /Chairman Attest tP~~.cA)~f'<<J Deputy erk Address for giving notices By President Attesf1~~d,j~ Gwen Ann L Salt Assistant Secretary Address for giving notices The Brewer Company of Florida, Inc. Monroe County Public Works Engineering Department 5100 College Road Key West, FL 33040 / D YCo ,/f.,: (.LJ. / dJ/ t<J 4r i' /11/ ,,4rJ1," rL 33/7 P / **************** /'PPROVrr> AS TO f!!(""'/! ~1~. ' FF~CfENCY. I~~ I~~~BY~ O..,CD ... 7 fq END OF SECTION 00500 09/09/94 FORM OF AGREEMENT 00500-7 . . . .~. I . (kl~~ 'Il" J" . , ., ~f J \'~~ iJ.r '.1 . I.; ! 1 f I I,' :.,~. ,r 1J ill ~/I .......L~;~.tl~.~"~ . '~~'~'~~';":''''''','~1'7''1''''1'"( "'C7:.,,!,,'_",i!"'-~ ~,'~'i,,~'...;:i;~ ..~.~..:.............~ """__.............__....................:___:.-.......,;.;;1.;.00., _.":: . I I BEC'TION DC I BID J?ROPOS\ I I I ':r:u n ,C: '1 U:' <: l,~.. b:! Bubm:i tted :'i . ,:l forms tne.:::.:;d :Ln this :lee!', TJ1 U I,l.li n,~ Jl J:~llmen.ts as', :Jl:.SJ.} in~;tr1:t:L:;d bc:;rein. I J.tg:! I~} .(ajD!;~i,'m i 2, ,::'. T Sill :;mnent on Pt: :' :: r:.1: :.~ t "'), ':~ ,:: ::. III C-:: Pages 2 4 5 7 8 9 10 11 12 1.3 - 16 1. JI.:: ;lO~;::L: i':):::nl If,:.C:: U '1 don Affidav i I 4 .;,-: :lY r:~'Hld. CO:1flict Tt,ere ~l':: J a ': E! - 5 :[1.,: :r-.FreI3 'i'lorkplace :F) . 6 11 i Hc:nc I 7 P: '. L: en un:ruction E:) I - I - I II II I ~ )~~ i ;'H r , , BID PRopm~' 1)'1110-1 t~~-____, ._dEJ''''...._... I I I I I I I I I I I I I I I I I I I " '"' ; + , " 1 ~, '~"'I" ~. I r;?: .'.,' r ' "'1 I___,_,_~"~_iif"""~;t'!f"~__'~i~.,l~.~~..~~:i:":~~'" SECTION' DOll( PROPOSAL )?OR~ BID TO: MONROE COWrY BOAR! OF CCUNTY )l'<N1;:) ONERS cf 0 PURCHASING DRPIIWrME:NT' PUBLIC SERVICE BUIlDING, ROOM 0 )~: 5100 COLLEGE ROAD, ,s'I'OCK ISLMD KEY WEST, F:LORIDA ;\\04.0 I Fn'QM .-r;~~. 6~~ ' " c: ';',. <1 ,7)1/ ", /, B D ,I.'\: : /,. ~ .' --< u..I(<~....:.;..__ .' -..:..!.~.L.:...L~-:J-.,.__. '1\$1"" , I '~'. 1/.1 ~ j I,' I...' ("L_' /1-, CL. ' J ~, I ;?/ _:_-_:"'~ iL,~- /17/ i<' /))/ . ----- / f'--'~ II " --:' -:;' / ./ /~---{'_~~0_~~ 0_ _._.____.__.-~{:;/~ The undersigned, having carefully e;{amj~l!;d the Wox,.: ,so u teJ Bnee Drawings, Specifications, Proposal, am ]\.ddenda tbe'eil .nd ether Contract Documents for the construc~iarJf: CUDJOE KEY ROADf I Cudjoe :Key Monroe County, FIc r-idcl and having carefully examined the site where the WQ~k ;:c be performed, having become familiar with :l .1 local C()ldit ems .including labor affecting the cost thereof, and b.:1'!:ir.-g familLu' j Zt~d himsel f with material availability, Federal" 3L:11:.e, and Lccal Ll\hJ, ordinances, rules and regulations affec t; ng perforrnar.,,' 'E; 0 r: the Wor.r:: f does hereby propose to furnish all labc r, mechanicsmperint:endents, tools, material, equipment, transportatton services. nlll1 incidentals necessary to perform and ccmplE!te said He.'-};; and "JQrk incidental hereto, in a workman-like mc,nner, in ccn ,:o:'rr,an=:e ,.lith said Drawings, Specifications, and other Cortract Docwre'1t. 'n:]ucling Addenda issued thereto. The undersigned further certifies that he bas. perso,la l)'"nspected the actual location of where the Work is to be perfc)rnedl together with the local sources of supply andtt:a1~ he unders':ald,; ::he conditions under which the Work is to le performed. l[he successful bidder shall assume the risk of any and all costs and delays arising from the existence of any subsurface or other laten'~:,:)hysical condition which could be reasonably anticipated by =eterence to documentary information provided and madE~ available ,md t:rom inspection and examination of the site. The undersigned shall perform the work: a1~ t;he Unit PI' LC(~ Indicated on the following Bid Form. 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C> '-.-/ :- .~ .1 ',./ 0 ,~ 1:5 .~ t~ \~ 1~ \~ ~~ \~ (II \~ ~ \(:'\ IS: \"" i~ I~ (') " 1] u , :J ,) :::J It, ~t - I} 0 . -r :J O:JJ 2 cO .Q, o;t> o co (II o~ ^ m;t> <1l ^~ '< ~~ ::00 00 ij~ (,1)- z =p. o m ~ lJ ::0 o < m ~ m ~ (f) (') 0 0 0 ::J rt- rt- (D -, <0 () ~ ,-t- 0 ~~~ " I'... " -1 r-, ::; " (C, " .....-i O:l 'R-, .... CD :::: I CD ?\ .... () 0 ~ 3 "0 n> ::J "-..... '< 0 ~~ -+, ~ ." ~ o' ... 0.: ~tIl 5" f> 10/12/94 001 10 -- .3 BID PROPOSAL rl:~ L',....,JI ~ r:t 11., ,"-';. . . o 1=:, 3 I I I I I I I I I I I I I I I . . = ~S::llN~~':"'~,;;:"1+~C~~~ I acknowledge receipt of Addenda No.(s} I have included pages 1 th~ 16 of the Bid Proposal which entails the pro~l Form , the Sworn Statem~f Public Entity Crimes ,the Non-Collusiojl Affidavit ,the Lobbyill and .s>mflict of Intere~ Clause~, the Drug-Free Workplacef( ~, the Bid Bond~, and the Public Construction Bond____. (Check mark items above. as a reminder that they aXe include(t~..: Mailing Address: '. lhe Brewer Company of Florida, InC. /()'-/('{) /VeL'. /cJ./ It/file;' / 117; ff/1J/' rL().i~ i)/'I 33/-71 Phone Number: (~{J6 30/ -351!J ,/ Date: / / ,- f-- 9L/' Signed: Walter R. Brewer (Name) President Witness: (Title) ~J1uJl ';ht~) (Seal) 09/08/94 0011. BID PROPOSAL THE AMERICAN I"~STITUTE OF ARCHITECTS I AlA Doaum.nt ,4310 BID BOND KNOW ALL MEN BY THESE PRESENTS, that wa THE BREWER COMPANY OF FLORIDA, INC. (ber. Usaon fullnam. lIDd addroA or lela! title of CODtrEtor) al Principal, hereinafter called the Principal, and fIDELITY & DEPOSIT CO. OF MARYLAND (bere i1ucn f\all D~O _d addrca or 181a! title of Surely) , a corporation duly organized under the laws of tha State of Maryland a8 S uraty, h.relnafter call.d the Surety, are hold and firmly bound unto MONROE COUNTY BOARD OF COUNTY COMMISSIONERS (boro inion fuU DamD and addrcu or I.Sa! title or Owner) .. Oblige., hereinafter c;alled the Obligee, In the sum of FIVE PERCENT OF AMOUNT OF BID Oollars ($ 5%------------------ ). for the payment of which 8um well and truly to b. mad., the said PrlnolpaJ and the said Surety, bind : our.elva., our h.lr., ex.cutors, administrators, successors and uslgn., Jolntfy and s.veraJly, flrmly by th... pr..entB. I WHEREAS. the Principal has submitted a bid for CUDJOE KEY ROADS II, CUDJOE KEY, MONROE COUNTY. (here macn l\11J Dame lIDd addntl aad delCrlpuOll otProj6Ct) FLORIDA I NOW. THEREFORE. if the Oblleee shall accept the bid of the Principal and the Princfpal .hall enter into a Contract with the Obligee in accordance with the tCrmJ of luch bid. and give such bond or bonds u may be IIPecifled in the bidding or Contract Documents with good Bnd sufficient lurety for the fafthful performance of such Contract and for the prompt paymcnt of labor Bnd materials fumiahed in the prolecutlon thereof, or in the event of the failure of the Principal to enter such Contract Bnd give such bond or bonds, If the Principal shall I pay to the Obligee the difference not to exceed the penalty hereof between the amount specified In said bid and luch larger amount for which the Obligee may in good faith contract with another pany to perform the Work covered by aaid bid, then thi- obligation shall be null and vofd. othcrwise to remain in full force and effect. I SIgned And ..aI.d this 8th day Of 19 94 THE OF FLORIDA, INC. I d I .~ 12 ~;) I ~ltn8.s) I I , { (Seal) Walter . Brewer (TItle) President FIDELITY & DEPOSIT CO. OF MARYLAND W~V iI(is,w.u Itness) [ /2 . ,(9Urll~ (. L~/ // --~ D. W. MATSON, III (TItle) Attorney-~act (Seal) ~ "t'.' .1 ~:.,t' _'1 ~. Brn i=J<uPOSAL aOll0-~~ Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND HOME OFFICE. BALTIMORE. MD KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by C. M. PECOT, JR., Vice-President, and C. W. ROBBINS, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By-Laws of said Company, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, does hereby nominate, constitute and appoint D. W. Matson, III and John W. Charlton, both of Miami, Florida, EACH................. ,<........ ,................................ I S rue an aw u agent and Attorney-in-Fact, to make, execute, seal ) ) er, for, <:s: Its behalf as surety, and as its act and deed: any and all bonds and undertakings....... /:....~~~\........................... n e execution of such bonds or undertakings in pursuanc ese prese all be as binding upon said Company, as fully and amply, to all intents and purposes, as if they had been duly ~. and ac~ ged by the regularly elected officers of the Company at its office in Baltimore, Md., in their own proper pers~~ls P~of attorney revokes that issued on behalf of D. W. Matson, III, dated~~~17, l~~iv The said Assistant Secretary does hereby certify th~~. xtract se~n the reverse side hereof is a true copy of Article VI, Section 2, of the By-Laws of said Company, and is now ~~. ~~ IN WITNESS WHEREOF, the said Vice-Pre~~nd A~Si n~ecretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND D~srr COMP MARYLAND, thiL---h--h_____ht2J.h________h__h__h___h_______day of ----_____NQ_Y..~~l>_~_!:____________, A.D. 19_2;t :~ ~ S:.!S-" FIDEL~D DE. Il' COMPANY OF MARYLAND~ ~ A TI'EST SEAL f' ~ - ~ q,:"''1L''.'I) By VicetresidenJ \ J ss: STATE OF MARYLAND COUNTY OF BALTIMORE On this___~_~_~h_h_day oL__Ng_yh~!!.ll'_~L____, A.D. 19_.9_3.., before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came C. M. PECOT, JR., Vice-President and C. W. ROBBINS, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. JS oo.OLJ~~L~~ My Commission Expires--h---________AJ!Jll1JiLl.._l9.22..________h CERTIFICATE I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the original Power of Attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 16th day of July, 1969. REsOLVED: . 'That the facsimile or mechanically reproduced signature of any Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this ~~~__ day oL__N~I~L~J!.!Q_~_L_________, 19_.93. L1428c -030-2074 --~""S<a~ry .....;~_-.-...... SECTION 00110 PUBLIC CONSTRUCTION BOND BY THIS BOND, We THE BREWER COMPANY OF FLORIDA, INC. as Principal and FIDELITY & DEPOSIT CO. OF MARYLAND , MONROE COUNTY PUBLIC WORKS DIVISION a corporation, as Surety, are bound to 5100 College Road, Key W~st, FL 33040 TWO HUNDRED THIRTY-SIX THOUSAND herein called Owner, in the sum of $ SIX HUNDRED THIRTY-ONE & 68/100 ($236,631. 68: for payment of which we bind ourselves, our heirs, personal representatives, successors, and assigns, jointly and severally. THE CONDITION OF THIS BOND is that if Principal: 1- 19~, Performs the Contract dated November 23, 1994 , between Principal and Owner for construction of CUD JOE KEY ROADS II Cudjoe Key Monroe County, Florida the contract being made a part of this bond by reference, at the times and in the manner prescribed in the contract; and 2. Promptly makes payments to all claimants, as defined in Section 255.05(1), Florida Statutes, supplying Principal with labor, materials, or supplies, used directly or indirectly by Principal in the prosecution of the work provided for in the contract; and 3. Pays OWner all losses, damages, expenses, costs, and attorney~s fees, including appellate proceedings, that Owner sustains because of a default by Principal under the contract; and 4. Performs the guarantee of all work and materials furnished under the contract for the time specified in the contract, then this bond is void; otherwise it remains in full force. 5. And this Bond shall remain in full force and effect for a period of one (1) year from the date of acceptance of the project by the Owner and shall provide that the 09/08/94 BID PROPOSAL 00110-13 ~.""""-;" -'.;',(' )--..........;:.."'...1-,1:..:..:- ",,,''tf~_.:t:..,.~-_;,' 'I ,.,-., .:'l....~.. .:...:. ~.~. J ._"1.' ...:r._' ..' .- ------.-...... Contractor guarantees to repair or replace for said period of one (1) year all work performed and materials and equipment furnished that were not performed or furnished according to the terms of the Contract, and shall make good, defects thereof which have become apparent before the expiration of said period of one (1) year. If any part of the project, in the judgement of the Owner, for the reasons above stated needs to be replaced, repaired or made good during that time, the Owner shall so notify the Contractor in writing. If the Contractor refuses or neglects to do such work within five (5) days from the date of service of such Notice, the Owner shall have the work done by others and the cost thereof shall be paid by the Contractor or his Surety. Any changes in or under the contract documents and . compliance or noncompliance with any formalities connected with the contract or the changes does not affect Surety's obligation under this bond. IN WITNESS ~mEREOF, the above bounded parties have executed this instrument under their several seals, this 14th day of December , 19-2L, A. D., the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. WITNESSES: (If Sole Ownership or Partnership, two (2) Witnesses required). (If Corporation, Secretary Only will attest and affix seal). I THE OF FLORIDA, INC. _---- Walter R. Brewer Presider).t (a f f ix Signature of Authorized Officer seal) " The Brewer Company of Florida, Inc. WITNESSES: ~fme of Firm / .wl- ignature of Authorized Nosistam ~ecrelary Gwen Ann L. Salt (affix Officer seal) Title /1)'1 tl() ,.4./ U). 1:::2/ iJ{) /1,2 i I Business Address ;n, /J I'lJ,';:L 33/1 P City State Zip ~ 09/08/94 BID PROPOSAL 00110-14 ....J'N~~. i1-~'WW.I'" __ ...L" ~_ _.. _ ._ . )~. SURETY: / : WITNESS: /d/jo.) A~ (affix III seal) Y~TSON-CHARLTON SURETY GROUP, 770 S. Dixie Hwy. Business Address Coral Gables, FL 33146 City State Zip " " I ,~ MATSON-CHARLTON SURETY GROUP Name of Local Insurance Agency .;, :j .j i 1 1 I ~~ ,I ,j ) ,. 09/0a/94 BID PROPOSAL 00110-15 _J -_t.~_~"~'<'''''~.___~''''L''''''''''~''~,r~.21.......,,~1IH''~''''''''_~_.tl~i.:!8'l.l~.&...'-'" - - .--.....-~-,_........._. '-~. - ........ .~.- ~ .'~ CERTIFICATES AS TO CORPORATE PRINCIPAL /12;;7. , certify that I am the Secretary I, Gwen Ann L. Salt of the Corporation named as Principal in the within bond; that Walter R. Brewer who signed the said bond on behalf of the Principal, was then President of said Corporation; that I know his signature, and his signature hereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said Corporation by body. SEAL STATE OF FLORIDA ) ss COUNTY OF DADE Before me, a Notary Public, duly commissioned, qualified and acting, personally appeared D. W. MATSON, III to me well known, who being by me first duly sworn upon oath, says that he is the Attorney-in-Fact, for the FIDELITY & DEPOSIT CO. OF MARYLAND and that he has been authorized by its President to execute the foregoing bond on behalf of the Contractor named therein in favor of the Monroe County Public Works Division. Subscribed and sworn to before me this 14th day of December , 19----2lL, A.D. (Attach Power of Attorney) Notafiflgtc -II~ State of Florida-at-Large My Commission Expires: **************** END OF SECTION 00110 OLGA ROQUE Notary Public, State of Florida My Comm. expires Apr 5, 19~ No. CC361893 09/08/94 BID PROPOSAL 00110-16 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND HOME OFFICE, BALTIMORE. MD KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by C. M. PECOT, JR., Vice-President, and C. W. ROBBINS, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By-Laws of said Company, which are set forth on the reverse side hereof and are hereby certified to be in full force andeffectonthedatehereof,doesherebynominate, constitute a ndappoint D. W. Matson, III and John W. Charlton, both of Miami, Florida, EACH............................................................ 1 S rue an aw agent and Attorney-in-Fact, to make, execute, seal and ~er, for, an~ behalf as surety, and as its act and deed: any and all bonds and undertakings.......... ~ . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . The said Assistant Secretary does hereby certify that 2, of the By-Laws of said Company, and is now in IN WITNESS WHEREOF, the said Vice-Presid Corporate Seal of the said FIDELITY AND DE md____~gy.~~Q_~_L___________, A. D. 19 _9-J_ () FIDELITY By n t e execution of such bonds or undertakings in pursuance Q amply, to all intents and purposes, as if they had been duly exe Assistant Seere STATE OF MARYLAND} ~ COUNTY OF BALTIMORE ss: ~ On this___~_g_r:.hm_day OL___~g_y~!!lt>_~I_____~.D. 19__9-3., before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came C. M. PECOT, JR., Vice-President and C. W. ROBBINS, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF ,MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. . I J ,/ ~s CAAOL-'~F~~--N';;;';;-P-;';'j;; ~ My Commission Expires__________________Al!g1t!!.LL.J_92~____d________ CERTIFICATE I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the original Power of Attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 16th day of July, 1969. RESOLVED: "That the facsimile or mechanically reproduced signature of any Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this !~-~-~--- day OLnP-!:_<:_~:l!E_~E____________________, 19__~~. L142& -030-2074 ~~ -------------------- ------- ---------------------------------- Assistant Secretary I I I I I I I I I I I I I I I I I I I SECTION 00110 SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to j},i);t)/.:'tE- {-f;(j /lJ/c (prin ~;/)#~ ()/: (fLiVA//? t{)f}/;)}/5~/!0~~c;; name of the public en ity) by Walter R. Brewer President (print individual's name and title) lhe Brewer Company of Florida, Inc. for (print name of entity submitting sworn statement) whose business is /D<!iv /f) (/J {;2( Ct)//(/ /ll/#J?l/, rc ~3/l1 I Employer Identification Number (If the entity has no FEIN, the individual signing this . ) and (if applicable) it F~deral (FEIN) is L~t';~- Co6-,ft/ 1 y include the Social Security Number of Sworn statement: 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statues, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including, but not limited to, any bid or contract for good or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statues, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere. 4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a),Florida Statutes, means: 1. A predecessor or successor of a person convicted of a public entity crime: or 09/08/94 BID PROPOSAL 00110-5 I I I I I I I I I I I I I 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or" income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that ope person controls another person. A person who knowingly enters into a joint venture with a person who has b,een convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287".133(1)(e), Florida Statues, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies.) 6. /' ~ Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. 09/08/94 BID PROPOSAL 00110-6 I I I I I I I I I I I - I I I I I I I The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (attach a copy of the final order) . ... I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN walCH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM TH PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OR THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, F ORIDA S FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAIN TEl FORM. Walter R. Brewer (signature) /'C/()(/!=n )~~.PI ) 9 9cj (date) STATE OF /I--f) KI Dft ';" 'l-b I=- -,_./ / ,- COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, Walter R. Brewer who, after first being sworn by me, Wa Iter R. Brewer (name of individual signing) affixed his/her signature in the space provided above on this ! day of "(/D//C)}I&_~K , 19 9</ . I/n J! /J Lit) (%~LtEt_l~, ~t~~~<-/ NOTARY PUBLIC My commission expires: ";;';';'';;';~'' DEBRA A. BROWN ,.. W€r'1 .., My Commission I CC 21W84 \.:~./ EXPlRES August 29, 1996 <~~:..., Bonded Thru Western SUl'€ty Company Form PUR 7068(Rev. 04/10/91) 09/08/94 BID PROPOSAL 00110-7 I, SECTION. 00110 NON-COLLUSION AFFIDAVIT I, Walter R. Brewer of the city of /llJ/I/J/)// /::-(~rJ~/)jA according to law on my oath, and under penalty of perjury, depose and say that; 1.) I am Walter R. Brewer President of the firm of The Brewer Company of Florida, Inc. , the bidder making the Proposal for the project described in the notice for calling for bids for: and that I exec~ted the said proposal with full authority to do so; 2.) the prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such process with any other bidder or with any competitor; 3.) unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder and will not be knowingly disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor; and 4.) no attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition; 5.) the statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for said project. 09/08/94 BID PROPOSAL 00110-8 (SiJ~~::::-Bidder) Walter R. ",ewer ~)[JJlEII)~~ f) /t/C; ;// (Date) STATE OF: /:2{'i,e/I)A 'b /l-b E COUNTY OF: PERSONALLY APPEARED BEFORE ME, the undersigned authority, Walter R. Brewer who, after first being sworn by me, Walter R. Brewer (name of individual signing) affixed hiS/her signature in the space provided above on this t day 0 f Il)tJ l/l:=:7J7 t:E--L , 19 tJ~1 dldtR/l ~4!t~) NOTARY PUBLIC My commission expires: ........ DEBRA A. BROWN :"~::&~'f'" My CommisSion # CC 218984 : ~ j EXPIRES: August 29, 1996 "'::~!.~:-:t.~., Bonded Tl1ru Western Surety Company 09/08/94 BID PROPOSAL 00110-9 I I I I I I I I I I I I I I I I I r SECTION 00110 LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA " The Brewer Company of Florida, Inc. " (Company) " warrants that it has not employed, retafned'or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract wi out liability and may also, in its discretion, deduct from the tract or purchase price, or otherwise recover, the full t of any fee, commission, percentage, gift, or consideration to he former County officer or employee". Walter R. Brewer ( gnature) AJIJI/t=7f? ,6cK- ~~ /99 ~I (Date) STATE OF r-:{~'~( 'J~ '.,!' Ll_), c-- ..u / / U '----' COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, Walter R. Brewer who, after first being I r 1 sworn by me, affixed his/her signature Walter R. Brewer (name of individual signing) in the space provided above on this f day of ~/Ot/EF)).6t=~ , 19 9i. _ ~ t:JJI~ d. ~/f!CCL~ NOTARY PUBLIC My commission expires: ...-..... DEllRA A. BROWN /'~""" My Commission Ice 218984 :. ~ j EXP1RES August 29, 1996 ",~:~!,~~., Bonded Thru Western Surety Company ~ 09/08/94 BID PROPOSAL 00110-10 t I I I I I I I I I I I I I I I I I I SECTION 00110 DRUG-FREE WORKPLACE FORM The undersigned Contractor in accordance with Florida Statute 287.087 hereby certifies that: The Brewer Company of Florida, Inc. (Name of Business) 1. Publish a statement notifying employees'that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform such employees about the dangers of drug abuse in the workplace, the business/s policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employees will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee/s community, or any employee who is so convicted. 6. Make a good faith effort to continue to maintain workplace through implementation of this section. / /~his As a person authorized to sign the statement, I cer. firm complies fully with the above requirements. Walter R. Brewer MCP#5 Rev. 6/91 Bid Signature ~i')Ve7)7LJ~;e_ S'; /v9y Date 09/08/94 BID PROPOSAL 00110-11 j'ACILlTIES OR ~.~ACH1(\JFS TYPE or flUSINFSS :U'~'~,ESS '[iLlHESS 'IA\1E r !f\ILI~JC .\DDnES~: CERTIFICATE HONROE RECEIPT NO. 517883 ISSUE DATE 10/19/33 LICENSE NBR 95-00098 OF .,;.CD!<1P E! EHCY ,.cOUNTY CC: ENG II 219D FEE DUE 150.00 LATE FEE .00 dE PA~ 150.00 c;;q:;01/[( ~ If h/~~ SECRETARY THIS CERTIFIES THAT BREvlER, IJlALTER B REvIER COf1P ANY 4825 S.W. 8ZND HIAHI R. OF FLORIDA STREET FL 33143 QUALIFIES AS A ENGINEERING CONTRACTOR CLASS II D IN GOOD STANDING AND iTH1S CERTFICATE OF COHPETENCY IS VALID AND IN FORCE UNTIL OCTOBER 31, 1995 _':;i~'""l,;,it ';~f;:!,,' ~-"._- -'~~--~---';' tJ 1994-1995 OCCU~TIONAL LICENSE STATE OF FLORIDA MONROE !100MS MUST BE DISPLAYED IN CONSPICUOUS PLACE EMPLOYEES SEATS 31-40 30140 CONTRACTOR ",rr~!~j'tf?-~~~~0:~:~:-'-l E N G I N E E R I N G.' v^' rn \ ( c ,'. .(:^/ __'~~~..J ~ -::~ ;~'\"' ~~_ &0"1)~ ;--- ~ ~-.~<~::'--/~~ ~-- ,J.fj'!:.c:.,'I.-~+/f _~ ~ "'0:(~~~\;.'~1. <'irc.:;--'/,.; ,.....:-=: _, _::.=:::" ~C"I"~o. f!/<\v / lU "'>4 '~,~ C', ;:/!{r-y//,r-,-' /-;? u) ~_ w \, v"'~:\\ !/~~J</c;~~i;~~ 1 ~~\ L~j~~ i,I'~'~ 1"1/" 0, I ,.'!, ~\'\r 0'\" './ ~I!b' , . . '" I J:;:_' ((\1' '1 I: (yJI ,iC. ~\. 1 _= ,- __, -1 _r"1~ \ ",J I. . I,~, .1 \ ~~ Co.:. ':'~! r::'}....., ,~ '<;:\; \ !j ~--- -- ,____... ,"'" l-;., ," ,,\'6 \ " /J11 ::..'g 33178 ~\.,c '. I .,<f.{, "j" '):i\\.... . r: ;1FJ, "'r" '~\\.-,:. \ 'b~/' :;;i~" ~~ ~ ~) ~..p1-:-~~. .-"-:? <..:-;J/~jl '~~;.~:o(;~... ._~;;~~t;;i;Y '~.v:.'- .^' r" \.f I H _-<;))1' ....., ',.l,;.\;,:;_~~.\J:t.-;J;:'; TYP.o MONROE COUNTY 00 - COUNTY OF MONROE BREWER CO OF FLA THE BREWER WAL TER R 9801 NW 106 ST MIAMI FL CONTRACTOR ENGINEERING 'filS BH~m,j[S .\ Ti\X , H A R R Y F K N I G H T C F C T A X CO L LEe TOR lcCCIf'fWHFN\~\I,!!.J,~JFDp 0 BOX 1129" KEY WEST FL 33041-1129 0000000000 0000007200 0000301400000308 1001 2 . ... ;". .~~ '.: " .'., f:~;,\'<-- . . \':". '.:.~ ' ". <;',';-.,; ",,\, .~ ' ';1 :',-\ ACCOUNT 30140-0000308 EXPIRES SEPT. 30" 1995 X SUi"PLEManAL J1Er,JEWAL NEW LICENSE TRANSFER. ORIGINAL TAX .AMOUNT PENALTY COLLECTIOtJ COST TOTAL "'lJ-tOO -i:I: P -, 'O:D D :J:> -Ol-ol1D -i ...(1 x :::0 0.. ~ -:t fT1 .=. :::IJ f-*o(")-t. ~..)O vJ r "Tl ......,...0,. .......elm ........ ........ j~;::r.:: ~<' 0- .=, ~ :z II .-.:J> ....... I:;::' 0 l-t .=1 I-a. G'1 -..0 .=1 ;Q Cl '='~..)""""'_"" :I: 72.00 72.00 ^tri 21. 199J III l'ririins MONROE COUNTY, FLORIDA _ INSURANC:O~ECKLlST I, VENDORS SUBM11TING PROPOSALS FOR WORK il ~. To assist in the development ofyouT proposal, the insurance coverageS marked with an "X" will ; . be required in the event an award is made to your firm. Please review.tbis fnrm with your .. insurance agent and have himlher sign it in the place provided. It is also required tfloa the bidder tl sign the form and submit it with each proposaL WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY WCJ WC2 WCJ WCUSLH x Workers' Compensation Employers Liability Employers Liability Employers Liability US Longshoremen & Harbor Workers Act Federal Jones Act Statutory Limits $100,000/$500,000/$100,000 $500,000/$500,000/$500.000 $1,000,000/$1,000,000/$ 1,000,000 Same as Employers' Liability . Same as Employers' Liability x INSCKLST l~;l-::!O, STJPl:)I,EMENTARY INSURANCE DOCUMENTS 00900-3 Api n. J99J lit ....... GENERAL LIABILITY . Products and Completed Operations Personal Injury . Premises Operations · Blanket Contmctual · Expanded Definition. of Property Damage I Required Limits: I GLI I GL2 x I IGLJ S100,OOO per Person; $300,000 per Occurrence S50,000 Property Damage . or $300,000 Combined Single Limit $250,000 per.Person; S500,OOO per Occurrence $50,000 Property Damage or S500,000 Combined Single Limit S500,OOO per Person; SI,OOO,OOO per Occurrence S100,OOO Property Damage . or SI,OOO,OOO Combined Single Limit ; ; I Required Endorsement: IGLXCU X Underground, Explosion and CoJIapse (XCU) GLLlQ Liquor Liability IAII endorsements are required to have the same limits as the basic policy. I I I I I I ^cIminiSlnli\'e InstJUdian . 1.4709.01 12/13/93 INSCKLST SUPPLEMENTARY INSURANCE DOCUMENTS 00900-4 l\fri 22.. 199J ,.. l'rinlinl VEHICLE LIABILITY As a minimum, coverage should extend to liability for. . Owned; Nonowned; and Hired V chicles Required Limits: VLJ x / $50,000 per Person: $100,000 per Ocairrence $25,000 Property Damage -, '" or $100,000 Combined Single Limit $ I 00,000 per Person; $300,000 per Occurrence . S50,000 Property Damage or $300,000 Combined Single Limit S500,000 per Person; $1,000,000 per Occurrence SI 00,000 Property Damage or SI,OOO,OOO Combined Single Limit MISCELLANEOUS COVERAGES Builders' Risk Motor Truck Cargo Professional Liability PoJlution Liability Employee Dishonesty Garage Keepers MedicaJ Profossional INSCKLST Limits equal to the completed project. Limits equal to the maximum value of any one shipment. $ 250,000 per OccurrencelS 500,000 Agg. S 500,000 per Occurrencel$I,OOO,OOO Agg. $1,000,000 per OccurrencelS2, 000, 000 Agg. S 500,000 perOccurrencel$I,OOO,OOO Agg. $1,000,000 per OccurrencelS2,OOO,OOO Agg. S5,000,ooO per OCCl1I'TencelSlO,OOO,OOO Agg. S 10,000 S 100,000 S 300,000 (S 25,000 per Vcb) S 500,000 (SIOO,OOO per Veh) ,$1,000,000 ($250,000 per Veh) $ 500,000/S 1,000,000 Agg. SI,OOO,OOO/S 3,000,000 Agg. $5,000,000/SI0,000,000 Agg. ;~/11/Q~ 00900-5 SUPPLEMENTARY INSURANCE DOCUMENTS IF Installation Floater Hazardous Cargo Transporter Bailee Liab. VLPl VLP2 VLP3 BLL HKLI H!.~J 2 HKiJ Hangarkeepers Liability Aircraft Liability Architects Errors & Omissions Apnl 22. I 'J'J] III t'rint-iug Maximum value of Equipment Installed $ 300,000 (Requires MCS-90) $ 500,000 (Requires MCS-90) $1,000,000 (Requires MC;3-90) Maximum Value of Property $ 300,000 $ 5~0,OOO $ 1,000,000 $25,000,000 $ 1,000,000 $ 1,000,000 $ 250,000 per OccurrencclS 500,000 Agg. $ 500,000 per Occurrence/St,ODD,ODD Agg. $ 1,000,000 per OccurrencelSJ,DDO,ODO Agg. INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the bidder named below. The following dcductibles apply to the corresponding policy. understand the insurance that will be mandatory if awarde vith all the requirements. The Brewer Company of florida, Inc. POLICY Comm. General Liability iability policies are ~ Occurrence Claims Made LON IDRTH CORW INSURANCE GROUP Insurance Agency Bidder INSCKLST -,..'.......,,.- ~,........~,.......,........T.--.'f""'" nn,-'''''''ltr-"''r,...,,('''' n0flnn r: ininntivc lmUuctlOQ DEDUCTIBLES $1,000.00 Property Damage /~- 'contract <!nd will comply in full Walter R. Brewer ':-:.:.:.:-:.:-:-:-..:-'.-:.:.:.:.:.:-:-:-'.:-:.:..:--.:.:-:.:-:-:-:-:-:-:-:-:.:.:-:.:.:-:-:.::-:.:-:.:-:-::-:-:.:.:.:.:.:-:.:.:-:.:.:-:.::.:.::.:.:-:-:.:-:-:-:-:-:-:-:-:.:-:-::-:-:-:.:-:.:-:-::-:.:-:.:-:.;-:.;.:.:.:-:-:-:-:-:.:.:-:-:-:-:-:.'-:.:-:.:-:-:-:-:-:.:-:-:.:-:-:-:-:-;.:-:-:-:-:-;-:-:-:-:-:-:.:-: -:-:-:-;':-:-:';':-:';':-;':-::':-:-;':-:-:-:-:-:-:-:-;':-:-:-:':':';';':-:-:-:-:-:'. ~EII1J'I~I~~...._~II_lg_IN~I~IQ4~~~ ISSUE DATE (MM/DDIYY) ON WORTH CROW INS GROUP .0. BOX 141916 ORAL GABLES FL 33114-1916 01/04/95 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A NORTHERN INSURANCE COMPANY LETTER COMPANY B ASSOC GENERAL CONTRACTORS INSURED LETTER REWER COMPANY OF COMPANY C LORIDA INC LETTER 0400 NW 121 WAY COMPANY D IAMI, FL 33178 LETTER COMPANY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICAtE MAY BE ISSUED OR MAY PERTAItt. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POllI.iIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 0 POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER LIMITS TR ATE (MMIDDIYY) DATE (MM/DDIYY) EPA24334576 1/01/95 1/01/96 GENERAL AGGREGATE $ 2 000 OMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 1 000 LAJMS MADE [iJOCCUA. PERSONAL & ADV. INJURY $ 1 000 OWNER'S & CONTRACTOR'S PROTo EACH OCCURRENCE $ 1 000 FIRE DAMAGE (Anyone fire) $ 50 MED.EXP. (Anyone person) $ EC85901155 1/01/95 1/01/96 COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE 86895225 1/01/95 1/01/96 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION 8801290 1/01/95 1/01/96 AND DISEASE-POLICY LIMIT EMPLOYERS' LIABILITY DISEASE-EACH EMPLOYEE OTHER DESCRIPTION OF OPERATlONS/LOCATlONS/VEHICLES/SPECIAL ITEMS OB: CUDJOE KEY ROADS II ONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS NAMED AS ADDITIONAL INSURED XCEPT FOR WORKERS COMPENSATION. ... ..................J~. ... . ...................<(<...........<.l.,~TJQ".> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCellED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAll-3...0-- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAilURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR lIABilITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. MONROE COUNTY PUBLIC WORKS DIVISION 5100 COLLEGE ROAD KEY WEST FL 33040 >i AUTHORIZED REPR~ TATlVE , ", ....,..-_ ...._ .....~~~.,<:. ~c(>'Q~(1:~r..